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Good Faith Estimates

Your right to a written estimate of expected charges if you are uninsured or not using insurance.

You have the right to a Good Faith Estimate

Under the federal No Surprises Act, health care providers, including dental practices, must give patients who are uninsured, or who choose not to use their coverage, a written Good Faith Estimate of expected charges before care is provided. “Self-pay” includes patients who have coverage but do not want a claim submitted.

What the estimate includes

The estimate lists the items and services expected to be part of your care at this practice, with the expected charge for each. It comes on paper or electronically, in the format you prefer.

When you receive it

  • If you schedule care at least 3 business days ahead, you receive the written estimate within 1 business day after scheduling.
  • If you schedule care at least 10 business days ahead, you receive it within 3 business days after scheduling.
  • You can also ask for an estimate before you schedule anything. You receive it within 3 business days after you ask.

Keep your copy. You will need it to compare against any bill you receive, and to dispute a bill if it comes to that.

How to ask for one

Call (813) 908-2444, ask at the front desk, or ask when you schedule. We will also tell you about this right when you schedule care or ask what care costs.

If your bill is at least $400 more than the estimate

You can dispute the bill. The dispute goes through a federal process called patient-provider dispute resolution: a reviewer who is not connected to the practice compares your bill with your Good Faith Estimate and determines what you pay. To learn more or start a dispute, visit cms.gov/medical-bill-rights, email [email protected], or call 1-800-985-3059.

Who this estimate process does not cover

This federal estimate process is for uninsured and self-pay patients. It does not apply to patients using Medicare, Medicaid, or other federal health care programs.

Questions

Call (813) 908-2444 or use the contact page. Suncoast Dental Partners PLLC, doing business as The Destination Smile, 16654 N Dale Mabry Hwy, Ste 1030, Tampa, FL 33618.

Your next step

Let’s talk about your smile.

Tell us what has been holding you back, and ask your first questions.

A consultation is a conversation, an examination, and a written plan you take home. Nothing is decided in the chair.

(813) 908-2444

Call the practice to plan your consultation. Ask about availability and any consultation or imaging fees when you call.

  1. FirstTalk through what you want to change.
  2. ThenHave an examination, with imaging if it is needed.
  3. Before you decideReceive a written treatment plan and fees.
Visit
The Destination Smile
16654 N Dale Mabry Hwy, Suite 1030
Tampa, FL 33618
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Hours
Monday – Thursday
7:00 am – 4:00 pm
Friday – Sunday
Closed
Your dentist
Mark J. Greenwald, DDS
The Destination Smile · Tampa